| NPI | 1215384839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 10296-c) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NV 1380P-S) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2024-05-23 |